Developing pelvic floor materials which can stimulate ingrowth of new blood vessels after implantation

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Developing pelvic floor materials which can stimulate ingrowth of new blood vessels after implantation

The aim of my research was to develop the new generation of synthetic materials to be used in pelvic floor repair in women with stress urinary incontinence and pelvic organ prolapse. These materials need to be designed so that they can stimulate a favourable wound healing and promote rapid angiogenesis while providing good structural support. The clinical need for such materials is now increasingly more recognized, as the complications associated with use of current vaginal mesh has come to public attention. This issue has been covered on a BBC television programme twice in the last 6 months [1] and also made the headlines after a parliamentary debate was held in July 2017 [2]. In the UK one in ten women will need a pelvic floor repair surgery during their lifetime for most of which a synthetic material will be needed to reinforce weakened tissues. Thus better synthetic materials that can integrate better into patients tissues are urgently needed to replace the vaginal mesh in pelvic floor.

In this project I worked on a Poly-L-lactic acid (PLA) polymer which is a highly biocompatible material that is commonly used in biomedical applications. I have constructed the scaffolds using a technique called ‘electrospinning’ which allowed fabrication of scaffolds with micro/nano sized fibres to mimic the organization of the natural tissue matrix. The resulting synthetic material, the electrospun PLA with random fibres, had mechanical properties close to those of healthy vaginal tissues. I have also functionalized these materials by incorporating drugs into them. I have used the female sex hormone, estradiol, in my scaffolds as it plays the most crucial role in maintaining normal structure and function of pelvic tissues in women. Additionally estradiol is known to stimulate new blood vessel formation.

My results demonstrated that estradiol can effectively be integrated into the synthetic materials without compromising mechanical properties and that estradiol can be gradually released from these materials to stimulate new blood vessels formation and a favourable tissue integration. The next step to take this research forward is to evaluate the estradiol releasing PLA scaffold in an appropriate pre- clinical model. The sheep model appears to be the most appropriate animal model to evaluate implants used in vaginal surgery. A sheep has a near clinical size vagina with 3 levels of supporting structures just like in humans.

With regards to my professional development as clinical academic, these studies have made a huge contribution towards completion of my PhD and I am hoping to submit my PhD thesis by December 2018.